Incident Report
Subform I: General Information
1. Report Type.
New incident report
Incident Report Number: 2008-4184
2. Registrant Information.
Registrant Reference Number: Prosar case 1-16402705
Registrant Name (Full Legal Name no abbreviations): The Hartz Mountain Corporation
Address: 400 Plaza Drive
City: Secaucus
Prov / State: New Jersey
Country: USA
Postal Code: 07094-3688
3. Select the appropriate subform(s) for the incident.
Domestic Animal
4. Date registrant was first informed of the incident.
15-JUL-08
5. Location of incident.
Country: UNITED STATES
Prov / State: CALIFORNIA
6. Date incident was first observed.
08-JUL-08
Product Description
7. a) Provide the active ingredient and, if available, the registration number and product name (include all tank mixes). If the product is not registered provide a submission number.
Active(s)
PMRA Registration No.
PMRA Submission No.
EPA Registration No. 2596-147
Product Name: Control One Spot Flea Egg and Larvae Treatment for Cats/Kittens
- Active Ingredient(s)
- (S)-METHOPRENE
- Guarantee/concentration 2.9 %
7. b) Type of formulation.
Liquid
Application Information
8. Product was applied?
Yes
9. Application Rate.
Unknown
10. Site pesticide was applied to (select all that apply).
Site: Animal / Usage sur un animal domestique
11. Provide any additional information regarding application (how it was applied, amount applied, the size of the area treated etc).
The reporter had applied the product to her 2.5 month old kittens on 7/7/08. She had divided the contents of 1 container of product between the 3 kittens. Per the label, the product is not designed to be used on animals younger than 12 weeks of age.
To be determined by Registrant
12. In your opinion, was the product used according to the label instructions?
No
Subform III: Domestic Animal Incident Report
1. Source of Report
Animal's Owner
2. Type of animal affected
Cat / Chat
3. Breed
Other
4. Number of animals affected
3
5. Sex
Unknown
6. Age (provide a range if necessary )
0.21
7. Weight (provide a range if necessary )
Unknown
8. Route(s) of exposure
Skin
9. What was the length of exposure?
>8 hrs <= 24 hrs / >8 h <= 24 h
10. Time between exposure and onset of symptoms
>8 hrs <=24 hrs / > 8 h < = 24 h
11. List all symptoms
System
12. How long did the symptoms last?
Persisted until death
13. Was medical treatment provided? Provide details in question 17.
No
14. a) Was the animal hospitalized?
No
14. b) How long was the animal hospitalized?
15. Outcome of the incident
Died
16. How was the animal exposed?
Treatment / Traitement
17. Provide any additional details about the incident
(eg. description of the frequency and severity of the symptoms
1-16402705: The reporter called on 7/15/08 to report the death of her three 2.5 month old kittens after application of a topical flea and tick product containing the active ingredient Methoprene. According to the reporter, she had divided the contents of 1 container of product among the 3 kittens on 7/7/08. The kittens had passed away the next day. The safety profile of the product was discussed, as was the fact that death would not be expected with recommended use of the product. No additional information is available. Note: Per the label, the product is not designed to be used on animals younger than 12 weeks of age.
To be determined by Registrant
18. Severity classification (if there is more than 1 possible classification
Death
19. Provide supplemental information here